What is the pathogenesis of lumbar disc herniation? A herniated lumbar disc is caused by degenerative changes in the lumbar disc and the rupture of the fibrous ring under the action of external forces, resulting in the protrusion of the nucleus pulposus and compression of the nerve roots, causing symptoms such as lumbago, leg numbness and sciatica. Repeated attacks of lumbar disc herniation can develop into secondary conditions such as spinal stenosis, resulting in walking with a limp, inability to straighten the waist, and even incontinence and paralysis in bed! Lumbar disc herniation is one of the most common clinical diseases of low back and leg pain. The number of people suffering from lumbar spondylosis in China has exceeded 200 million, of which the number of patients with lumbar herniation has exceeded 80 million 2. What is the difference between Chinese and Western medical concepts of lumbar disc herniation? Lumbar disc herniation is a Western medical term, while Chinese medicine is called “bone paralysis and lumbago”, that is, soreness of the waist and knees. Western medicine is named from the perspective of the cause of the disease, while Chinese medicine is named from the perspective of the symptoms. 3.What are the hazards of herniated lumbar disc? A herniated lumbar disc can cause dull pain in the lower back or lumbosacral region, restricted lumbar activity, muscle stiffness, numbness, coldness, radiating pain, string pain in one or both legs, and muscle weakness leading to limp walking, incontinence, and even paralysis in bed! 4, self-diagnosis of lumbar disc herniation: self-diagnosis criteria of lumbar disc herniation are as follows: -1 lumbar pain, accompanied by radiating pain on one or both lower limbs, coughing or forceful urination and defecation can make the pain worse, bed rest may reduce; -2 numbness on one or both lower limbs, mostly with the former; -3 intermittent claudication; -4 lumbar stiffness, loss of physiological pronation or lumbar lateral curvature; -5 pressure pain in the lumbar region, and pain radiating to the The straight leg raise test is positive, in which the patient lies on his or her back, straightens the affected knee and lifts it upward, with the affected knee lifted at a lower angle than the healthy side (the angle of bilateral lift is symmetrical in normal subjects). The following figure shows the straight leg raise test: 5. What are the traditional treatment methods for lumbar disc herniation? The traditional methods of lumbar disc herniation include: general medicine, physical therapy and surgery. Conventional therapy Disadvantages analysis Reasons for recurrence Common drugs:cannot safely dissolve the diseased tissue and hyperplasia, and can only temporarily relieve the symptoms and cannot repair the ruptured fibrous ring. Patients who have been taking painkillers for a long time are prone to drug dependence and cannot repair the ruptured annulus fibrosus. Physiotherapy: massage, massage and massage are more effective. Surgical treatment: Surgery involves more muscle stripping, more pain, more expense, and because the surgery is performed in a dense nerve area, it is very easy to damage the nerves and cause paralysis. In addition, it is difficult to control the infection after surgery, and the diseased tissue and growth will continue to grow, after which the nerve may be compressed again. 6, routine examination of herniated lumbar discs Herniated lumbar discs generally require X-rays, CT scans, magnetic resonance imaging (MRI) and other examinations, but it is also necessary to choose a more economical and accurate detection method according to the different sites of onset. 7, common classification of lumbar disc herniation Generally, according to the degree of herniation of the nucleus pulposus, the lumbar disc herniation can be divided into four types of bulging, protrusion, prolapse and free, of which bulging, protrusion and prolapse are more common, free is relatively uncommon. 8, the lumbar disc herniation easy to attack site lumbar disc herniation to L4-5 (i.e. lumbar 4-5) most common, accounting for about 58-62%; L5-S1 (i.e. lumbar 5 sacral 1) second, accounting for about 38-40%; L3-4 less common. L4-5 is the most common because these two gaps are subject to the greatest pressure and activity, and the posterior longitudinal ligaments located in these two gaps are relatively narrow, only 1/2 of the upper width. Specifically, as shown in the figure below: 9. How many lumbar vertebrae are there? There are five lumbar vertebrae, namely L1, L2, L3, L4 and L5 (see figure above), which are linked together by intervertebral discs, ligaments and synovial joints. The lumbar spine is located between the thoracic and sacral vertebrae, bearing the weight of the upper body, in the spine of the weight, is the movement of the trunk pivot, so it is very easy to cause local injury. 10.What are the parts of the intervertebral disc? The intervertebral disc is a cartilage tissue between two vertebral bodies, there are 23 of them. Each disc consists of three parts: (1) the nucleus pulposus: a jelly-like substance located in the center of the disc, most of which is water, the nucleus pulposus accounts for 50-60% of the disc surface; (2) the annulus fibrosus: the fibrocartilage surrounding the nucleus pulposus, closely connected to the upper and lower cartilage plate and the posterior longitudinal ligament of the spine; (3) the cartilage plate: the upper and lower cartilage surface of the disc contacting the vertebral body, the cartilage plate is also known as the end plate. 11.What are the main accompanying symptoms of lumbar disc herniation? The main concomitant symptoms of lumbar disc herniation are: sciatica, spinal stenosis, lumbar spine osteophytes, lumbar muscle strain, etc. 12.What is the relationship between herniated lumbar disc and the occupation? Lumbar disc herniation can be seen in all walks of life, but generally those engaged in heavy physical labor are the majority, such as farmers, workers, miners, construction workers. In recent years, the incidence rate of some non-manual workers is increasing year by year, such as office workers, teachers, soldiers, etc. 13.What is the relationship between lumbar disc protrusion and age? Lumbar disc herniation is mostly seen in young adults aged 20-50, and this age accounts for 80% of the total incidence. 14.What is the relationship between herniated lumbar disc and gender? Lumbar disc herniation is generally more common in men than women, which may be related to the physical work undertaken by men more than women. 15.What is the difference between lumbar disc bulge, protrusion and prolapse? The difference between lumbar disc bulge, protrusion and prolapse is as follows: degree of protrusion fiber ring pulp nucleus bulge disc fiber ring partial rupture degenerated nucleus pulposus protrudes through the weakness of the fiber ring; protrusion fiber ring has completely ruptured degenerated nucleus pulposus protrudes through the rupture of the fiber bulb. Both the prolapsed fibrous ring and the posterior longitudinal ligament are completely ruptured The degenerated nucleus pulposus breaks through the posterior longitudinal ligament of the fibrous ring and enters the epidural space from behind the posterior longitudinal ligament, which can cause extensive nerve root and cauda equina injury. Bulging, protrusion, and detachment indicate the degree of severity of lumbar disc herniation. As the disease progresses, the rupture of the annulus fibrosus and the posterior longitudinal ligament may expand further, and the bulge may evolve into a protrusion, and the protrusion may develop into a prolapse, and the prolapse may then develop into a free one. Therefore, patients must be treated promptly to avoid further prolongation of the disease!